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No, ,21.80
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
)-c,i.~\_f _J~_r'."t'_<:--___ ____,_________, deceased.
Harold B. McLane, Deputy
To niel1s.rel C. t,~a@rB8~. Register of Wills for the County of Cumberland,
in the Commonwealth 01 Pennsylvonia,
IS
Petitioner(~ Q+e. the execut~'-l:-,--- _ named in the Last Will and
Testament of __Jdlc:l- f., '~y..oil!:C.--,------_.- dated Mv~ll 1"IG,j
Decedent was a citizen of the United States and a resident of
F(-~ t /1,,,'ub..rv7-:'.v"' J. ,'j) .:f'.owr:lship-
E 1" I..... 130''''''91:1, Cumberlond County, Commonwealth
af Pennsylvania.
Decedent died on Ihv'r.lAc., the Iii" day of In'1VMV ,
! I
A. D. 19~, in the County of _D"v ~,h, '1 State of
'/ / I' c(
) 'VI", ,dllf"," c... at the age of '" years.
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-has-- ' hos -Re-r-
Decedent has not been married and has not had children born to him
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
~ /.) (.,00. 00 ond of reol estate to the value of
.
Jl/L,I"l't..
os near as can be ascertained; said real
/V<>'1(.
estate situated as follows
OPP4t-
Therefore, your petitionertil respectfully applies for the probote
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated ').(", v Co' '. .:2 \ I '1 g()
( ,
Name and address ,~(;i~t,,' (4.!tCJ Rlct !'J.~( tt.i).)
of Petitioner(s)
If g'J-O (~t,^,~!' ,
r?!nv -11rl i;) ,1/tF)
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
_::r p" tv"," L C,,_jJ-I_j~I~~.-i~i.:0.'~":- L,~ 15,."",
named in obove application, being duly
say(s) that the statements set forth
S"", ( V v, ___ according to law
111 this petition are true to the
best of
,.., v
I
_ and
knowledge and belief
_~___,j)J.L~-~_.~,:~__,Ji_L_{';'!' !!.l 'L ( (' [.I~ C)
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sworn
subscribed before
me, _-.-.J~~I1~EX:-~-~------ 198~ ---
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~~_llj~~- ,-,-p--,{;r-fjr::-<~L Del'\lty
n;GI.BreJ c. t.ASgrCQf'l, Register
'h'll ill [Ii,' Iii!)
_ _ "._.___._,____,_..,____--'._~_.._L_:_.---~--.,------
Filed;
1980
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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA I ,.;,,,
COUNTY OF CUMBI<:HLAND \
,
'l'his................................. ..::"............ ..................... day of .............' ....... ..,..' ......,..,... ,....., ..........., ....' A, J)" 1 fl.........
,
"
before me Richard 1<:, Andel'H'nl. Register for the Probate of' Wills and gl':lnting letters of Administration
in and lilr said County of' Cumberland,_ in the Commonwealth of' Pennsylvania, personally wme ..........,...
........................................................................................................"................,.........................,...........................
the subscribing witnesses to the lilregoing inHtrument of' wiiiting purporting to be the last Will and
". ,/
Testament of' ,,"," .........', ........"............""..".......,...". ..,.,0",.,....,..",..",.."..,"",., Da ted .." ...."..""",..,...,.........,.,...
late of ,..",.......,.............,.",",.,...,.....,..,'" ...."",."."..".,:.."..""";,.."....,, ......", Cumberland County Pa" deceased
,'" .
who being duly,.....................................,.... acc(lrding to law. delloi:i.e and say. that ........................................
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present. and saw and heard the testa,/............................,' .............................................................................
/ '
sign, seal, publish, pronounce a1)d1eclare the said instrument of'writing t;~'at1d for h.............,.. Testament
and Last Will, and at the '~of so doing ,................................................was ~f.sound and disposing mind
ding, to the best. of ..............................................knowledge, ob's~l:vation and belief.
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............... .............................. and subscribed before
Richard E, Anderson, llilgister
....................................................................................
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA t ss:
COUNTY OF CUMBERLAND \
... .............. ... ... .... ..',.,........ .',... .~, ".,...e~,!:~.:,~. ::~... ..~.:,',G"I.. .1'1'" .f~:..~.:.'..! ~.. /~!:.:.~:,~. ..!~,~. ,(.!.~!:~.::.being duly
................................................ says that as nearly as can be ascertained the said decedent ..........................
.. .......,..,..... .:I.~:.h.~... ,..l.,:.".,D.!,!.:".~,...~..,.. .',.. ,.."......' ...' ,.. ,..',..', ..."., ......,.... ",... ..',......',.. ,.', ,... ........,.', .died on
........:n.~;:.~,d.'.'.,.................. the ..............L?...:.~.......day of ........J::i..:..~..::.:;......................... A.D., 19,.r.~.,
I '~
at or about ......................::::.~:............. o'clock, !:,M.
.....................!!~9.!:.~........,..........and subscribed this
........................n~.~.............., day of .....~,':':?~.'~D'..,
19,~~....., before
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Kklw,ld . All ~....,II Rcgl:ster -
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PI~NNSYLV ANIA 1
COUNTY OF CUMBERLAND ,
I
tis:
Before me, the ReJ.(ister 1'01' the Prohate of Wills und J.(1'antinJ.( of Lett.ers of Administration in 'und for
the County of Cumberland. personally came ....,..,...,P.',',,:t...'..~,'~,!,'~~,..,',t...,...(':...I.,!,.,'"..".....,.........,..,.........
who, being duly ....,'.'i.,~~,,;:,r:,'0........ doc?,;i....., depose and say that as.......r,"',\.,~,;J~,!..,~..................................
of the last Will and TestamentoI' ............L"J;.\....,r.,.....4,!.!.~!,f.,::,;....,..,...............................,.....,..deceased
......:~..~.:~........ will well and truly administer the WllIds and chattels, riJ.(hts and credits of said deceased
according to law. And also will diliJ.(lmtly comply wit.h the provisions of the law relatinJ.( to 'l'ransfer
Inheritances. ......t;I,~~.~~........... and subscribed
before me.
...............o!.~.~~~.~y...?~...............,.. A, D" 19 .~?......,
'-JI7! In' .
.....%f:M~":f.~r[~:{0/:1'..Q'=..,..,..,,.P~.~~~.Y...
Riill.aul E. Afl~~rTJn, Register --
f.,.:JP.(~;,~.;:~:. .~{,.r.~!l:~.I,:~:~,,( .~~.~~,. )...., ,....,...,.. ...
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DECREE
Be it remembered that on the ..........~~.~~..... day of .....................~~~~~.~y............, A. D., 19 ~~...., there
was probated and recorded the last Will and Testament of .......~.<:>,~~...~.~...~~,~~~.~.....................................
late of ..........~~.'!',~...~.~~.~~!?<<?!:~...'l::~~!!~~,~J.?......,......, Cumberland County, Pennsylvania, Deceased. Letters
............. .......~.~~.~.~.~.~~.~~;(.,..... were granted to .',..' ,.,..~~~.~ ~~.~.~.,~~~., ,~.~.~~~,7.,..(.~~,~.~~"....................
Witness my hand and official seal the day and year aforesaid. ~
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~,..~:~JjiS.,.'rrtri\~.~,~f.~~y.
1...1.....d E. UF1"''''', Register.
"
.
PENNSYLVANIA INHE1lITflNCE TAX GENEIlAI_IN~OHMAII()N
.------.--------..-------'--.---------.-- ----
1. PERSONS RESPONSIBLE FOR RETURN
-.--,-----..-
Section 701 of the Inherit,mr.e ilnd Estate Tilx Act oll9Gllllovidl:s thillthe 1011'1willp,l'ersons shall prepare and file
a return:
a. The personill represenlative of the estate of the decedent il" to IIlOlIerty 01 the decedent ildmllllslelcd hy hrm
and such ildditional plOperty which is or may be subject to lnheritrmce fax 01 wl,ich he/she sh<lll have or
acquire knowledge;
b. The transferee of properly upon the transfer oll'lhlch Inherililnce TilX IS or may be imposed by the 1961 Sliltule,
including a trustee of property transferred intlllst, providedihilluo sepillate retufllnecd be made by the trilnsferee
of property included in the relurn 01 il person;rl represc:rtiltive,
2. PLACE FOR FILING
The return is to be filed in duplicate with the Register of Wills ollhe county whereill the decedent resided.
3. TIME FOil FILING
The return is due nine mnnths il!ler the decedent's death. ullless il[\ exlensioll tor tiling has been applied fDr and
granted by Ihe Secretary of l~eYenuc within the nine-month period.
4. FAILURE TO FILE RETURN
Section 791 of the 1961 Statute provides that" , . .any person who willfully fails to file a return or other report
required of him. . .Shilll be personally liable. , ,to a penillty of 25% of the tax ultimately found 10 be due or $1,000
whicheyer is Ihe lesser to he recovered by the Department of Revenue as debts 01 like amount are recoverable by
law."
5. TAX RATES
Inherilance Tax is payable ot the rilte 016%on transfers to lineal descendants, such as father, mother, husband, wife,
son, daughter. grandchildren. grandparent, son-in-law and daughter-in-law ,1I1d at the rate of 15% as to illl others.
6. PAYMENT OF TAX
The tax assessed on the tr,lnsfer of property reported in the return is due 9 months after the decedent's death. Interest
at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any
interest which may be due with aoy remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE
DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED.
All checks should be made payable \0 the Register of Wills of Ihe county wherein the decedent resided and are
received subject to the fin;]1 determinillion ollhe Department 01 Revenue,
7. FAILURE TO PAY
The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until
the taxes and interest Ilave been paid in full. The taxes may be sued for against any real property in the decedent's
estate or against any property belonging to a transferee liable for the tax.
8. FILlNGOF FALSE RETURN
Any person who willl,llly mdl;es a false return or report required 01 him Sllilll, rn ilccordance with Section 793 of the
1961 Statute, be guilty of a misdellleanor ilnd, on conyictionthereof. shall be sentenced to pay a fine not exceeding
$1,000 or undelgo imprisonlllelltnot exceeding one year or both.
REV.451 EX+ (3.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
.
(Instructions on Reverse Side)
Estate of
John E. Briner
ESTIMATED DEPARTMENT
ITEM DESCRIPTION UNIT MARKET VALUATION
NO. VALUE VALUE (OFFICIAL USE ONL)li
1. CCNB Checking Account #320-0267-7 $ 3,295.34
2. CCNB Savings Account #032-121386-0 l~5.86
interest accrued to Date of Death .05 5.91
3. CCNB CD #18055 $10,000.00
Interest accrued to Date of Death 209.03 10,209.03
4. Personal property
Hide-a-bed sofa 90.00
Desk and chair 40.00
Vinyl recliner 25.00
Stuffed chair 10.00
Coffee table 5.00
End table 5.00
T.V. set 100.00
Pole lamp 10.00
Desk lamp 4.00
Li ving room rug & bedroom rug w!pad 60.00
Dinette set 15.00
3-piece bedroom set 190.00
Rocking chair 1+0.00
Old lamp 4.00
Vacuum cleaner 125.00
Card table and chair 10.00
Dishes, miscellaneous household and 95.90
personal items 828.90
5. 1977 Ford Granada 2,600.00
6. Security Deposit reimbursement 201.03
7. Federal Employees' Group Life
Insurance Check; Claim #675506 4,500.00
Interest accrued to Date of Death 74.90 4,574.90
8. Sony dividend 8.80
9. Telephone reimbursement 25.28
TOTAL THIS PAGE $ 21,71+9.19 .2/, 1 'f 7 "a.
v
1. Did decedent, within two yenrs of dentll. nwkc any trnnsfel of any materinl pnrt of his eslnte without receiving
vnlunble nntl mtcClllnte considemtion? (Answer "Yes" or "No".) I.'
2. Did decedent, within two yenrs of deatll, tmnsfer property from himself! herself to himself/herself nnd another party
or parties (including a spouse) in joint ownership? (Aoswer "Yes" or "No".) -"-
3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, prDvide the fDllowing
information:
a. Age of decedent at time of transfer.
b. Copy of death certificate.
c. Affidavit by the attending physician indicatinp, the state of decedent's health at time of transfer.
d. All other information supporting nontaxability of transfer.
4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration
therefor which was to take effect in pDssession or enjoyment at or after his/her death? (Answer "Yes" Dr "No".) '0
a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject
to his/her power of dispDsition? (Answer "Yes" or "No".)
b. What was the transferee's age at time of decedent's death?
5. Did decedent in his/her lifetime make any transfer withoul receiving a valuable anti adequate CDns:deration therefor
under which transferor expressly Dr impliedly reserves for his/her life or any period which does in fact end before his/her
death:
a. The possessiDn or enjDyment Df Dr the right to income from the property transferred? (Answer "Yes" Dr "No".) ~
b. The right to designate the persons who shall pDssess or enjoy the property transferred Dr incDme therefrom?
(Answer "Yes" or "ND".)
6. If the answer to five h. above is "Yes," state whether the right was reserved in decedent alone or others.
QUESTIONS CONCEHNING PROPERTY TRANSFERS
7. Did decedent in his/her lifetime make a transfer, the consideratiDn for which was transferee's promise to pay income
tD or for the benefit or careof transferor? (Answer "Yes" or "No".)
8. Did decedEnt, at any time, transfer property, the b61eficial enjoyment of which was subject to change, because of
a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation Df
law? (Answer "Yes" or "ND".)
9. if the answer to eight abDve is "Yes," was the pDwer to alter, amend or revoke the interest Df the beneficiary reserved
in the decedent alone or the decedent and others? (Answer "Yes" or "No".)
,REV.4'54 EX+ (3.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
*
SCHEDULE "E"
JOINTLY OWNED PROPERTY
(Instructions all Roverse Side)
Estate of John E. Briner
P . .
TOTAL E VALUE OF DEPARTMENT
ITEM DESCRIPTION MARKET \ DECEDENT'S VALUATION
NO. VALUE N INTEREST (Offici,,1 Use Olllvi
. T
NONE
(
" .
.
TOT AL THIS PAGE $0.00 -0-
--ifl}ft
INSTRlICTIONS FOR COMPI.ETING SCHEDLJL E "E"
Schedule "E" mUSI include all property. reill ill1d pe"ollill, llWIWd l1y II", d"cedl'II' i'"l1tlv vlill' allother
partY or parties as joint tenants with ri(Jllt of survivorsllip, BOlhlanqiill" ",,,1 iIlI:HI,,,IlII: prop,:!ty i1n! 10 be
included. List real estate first.
1. Describe all real property as illdicatcd ill tile ",,;tIIl"\lOIIS lor ~;c!",dlil" "A", U",.'Tlill> all n"r~oll,i1l'roperty
as indicated in tile instructions IN Schedule "If', Il1clllde II,e 11<1111", illldll''5 ,,1'1<1 ",I,lllllll""t,;p WI!li)
decedent of the co.owner (s) and the date Ille joilll oWllelshil' WilS I>slilhli,ihul.
2. Indicate the total market value 01 tl1e joilltly owned I'rol',"ly,
3. Indicate the percentage of the decedent's interest.
4. Indicate the market value of the decedent's interest.
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Dote of Death
INHERITANCE TAX SlIMMARY SHEET
(BUREA_~_.!:l~~ ONLY)
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;f'oA tV If, 4r..iAle/(.-----
/-11~1t2
R[V.4tJli [)(, (3.11111
File Number
Estate Nome
Social Security Number --- ' -
REPORT OF INHERITANCE TAX APPRAISER
I, tho unde"jgned duly appointed Inheritonce Tax Appraiser in and lor the County 01 Cumberland
Pennsylvania, do respectfully report that I have appraisad the real and personal property as reported in the laregaing
return at the values set larth apposite each item in the last column to the right in Schedul.s "A", "B", "C", and "E"
Dated:
9 - iI..:L-=.?.1L----
YfJA,,;,J) /!/~Jld"'l.)
INHERITANCE TAX APPRAISER
INVENTORY
YALUE AS APPRAISED
CODE
ADJUSTMENTS
(HARRISBURG USE ONLY)
REMAINDER APPRAISEMENT CODE
92+
Real Propertv (Schedule A)
Personal Property (Schedulo B)
Jolnt.Held Property (Schedule E)
Tronsters (Schedule C)
$
oat
TOT AL GROSS ASSETS
ol /, 11./ lOt
o 2llt
tJ 3Dt
__rZll.-7...1!L- a
93-
Leu D.bts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
40-
Valuation of life estates or
annuities. . . . . . . . . . . . . .
~
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGISTER ONLY
T OJ( on $
~
COMPUTATION OF TAX
$
$
$
$
6%
15'}r
'TaxonS
Tax on $
To..: on $
$
lox on $
Exemption!>
Total E$tato
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
Loss Crodits
DATE OF PAYMENT ~~ DISCOUNT INTEREST
S + 5 5 .
--
+ .
BALANCE 5
TAX CREDIT
$
INTEREST FROM
BALANCE DUC
TO __ S
S
GENERAL INHERITANCE TAX INFORMATIQ!'.!
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate.
In addition to debts incurred by the decedent or estate. other items are claimable including the cost of administration,
attorney fees, fiduciary fees. funeral and burial exp~nses including the cost of a burial lot. tombstone or grave marker.
All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed
shDuld be attached to this schedule.
A family exemptiDn of 82,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania.
If there is no spDuse, or if the spouse has forfeited his/her rights. then an,! child of the decedent who is a member of
the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same hou">ehold as the decedent. The family exemption is
allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws.
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INSTRUCTIONS FOR COMPLETING SCHEDULE of''
1. If the family exemption is being claimed, indicate the claimant's name. address and his/her relationship to the
decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column.
2. Assign consecutive numbers to each item listed,
3. Enter the date on which each debt was incurred and/or paid,
4. Enter the names of each payee.
5. Provide a brief explanation in the remarks column for each debt claimed.
6. Enter the amount of each debt being claimed.
7. The form must be signed by the person who has assumed the responsibility for paying the debts.
-'-
}.:;:"11-1 S
COMMONWEALTH OF,pr.mISYL',AHIA
COlJNTY OF CllMB&R~AtI9- r.,L~L
5S:
I, Patricia Lce Briner (Coil)
late of East Pennsboro Township n- ,_n-_' Cumberland County. Pa.. dece.sed and that tho
within is an inventory mado by, Patricia Loe Br:lJ)er(Coll)__ - ---. tho said-__Executrix--- ----
of fhe entire estate of said decedent, consisting of all the personal prop.rty and real estate. except real estate outside
the Commonwealth of Pennsylvania. and that the figures opposite each item of the Inventory represent it's fair yalue
as of the date of decedent's death,
sworn .. according to
Executrix
law. deposes and s,'ys that she ' irLtho
01 the Estate oIJ.obI1_.!>:__BEi,nc!,--
being duly,
SWORN
and subscribed before me,
; " h ~ '
,J~,IL"..LuL-'JQ'_.)J!h!'PU ~"~)-
hoeulor . Adminiitrator
~ ~,-__-1JjL
Ql)gQ;;:J '-, ~~
COr__" 'Vicf(,aUJ NOTARY p BLlC IN AND
FOR BELL C U ;ry, TEXAS
MY COMMISSIO E~IRJS
THE ~.__ DAY OF
~ ._---~
19 - -.l.!7~11
Date of Death __" _ _d ---'-' ..-----..--'
0s,':o_CI-1,L:.l:CI.t<::I':.-
~~\'?-{)J'..jj, (JI)&U!...__1~/1.i
AddrOH
D.y
,____~~\la!J'.-_- __
Month
..--,,-_._-------~_.__._-_._---'----_.,
1980
VellT
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal repre~en~ative.
2, A supplement inventory must be filed within thirty days of discovery of additional assets,
3. Additional sheets may be aitached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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DATE - ',,' -
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FILE NO. ....,{'/ J'I- >(?:-
COUNTY OF / ,/,/ h~'" ?€. 6(J - ..P
For County ,Information purposes only
___~:~:~LE :0: __~~~~ la:!~ _~_________u~___~A~:~=~~~:_~:_~~_~~~~_
RCC-84
(a.77l
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
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Appraised Valu. of Estoto:
R.ol Estale
Person.1 Prop.rty
Jointly H.ld Pfop.rtyITrensfero
Tot.1 Gross Est",8
Tot.1 Approved D.ductions
Cle.r V.lu. of ESt818
L...,: Approv.d Cherltebl. Ex.mptions
CI..r V.lu. of ESlele SubJ"", to Tax
Amount T.xobl. @ 6% ROle
Amount Tox8bJ8 @ 15% Rat.
Loss ,Cr.dits:
DATE OF PAYMENT
, OfFICIAL NOTICE Of
INHERITANCE TAX
ASSESSMENT
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$
taxdu.
$
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$ .~5"~n 1'1
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
INTEREST
TAX CREDIT
1-:1 y-J'II
AMOUNT PAID DISCOUNT
$ .,'/.J,-/",/J, If + $
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BA\,/\NCE.QF PENNSYLVANIA INHERITANCE TAX DUE
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$ (3:1 -(1'~,J~./
Inl.r.st will accru. .1 tho rale of six (6) percenl per annum on Ihe unpeld balance of
Inheritance' Ux from to the dele of payment.
~EE "EvER~E SIDE FOR IN~TRUC110IlS
REGISTER OF WILL'S COpy
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INSTRUCTIONll
To Insure proper credit to your lecount, the "Ime of the estate and file number .hould be clearly print~
ed on the check or money order.
ThiS assessment is made In accordance 'with Section 708 of the Inheritance and Estate Tax Act of
1961(72 P.$, ~ 2485-708),
To the extent that inheritance tax is paid withi'n three (3) months, after the death of the decedent. a
discount of five (6) porcont is ollowod (72 P.$, ~ 24B5-716).
InheritanCe Tlx.. oth~t than tax on 8 future ,interest, is due at the date of. the decedent's death and, becomes
dOl,inquent 01 tho expirotlon ofnin. (9) months oil", tho doced..nt's dooth (72 P,S. ~ 2495-711), Inhoritonc..
Tex on a future Interest it payable within three (3) months .fter ths transfer takes effect in pos.esslon and
onjoym..nt ond is dolinquontthoroelle( (72 p,S, ~ 2485-7121.CelculalO in10ro.' from 1he dolinqu..nt date shown
on the face of this form to ,the date of actual plvment using the'following interes,t table:
----~+----------'~~------~--------~- -------------- - ~ ---- ---~-------...,...... -- --- -- --
1 month ,006 4 months .D2D 7 months ,035 1 D months ,D50
2 month9 ,010 6 months ,025 8 mO'nths ,040 11 months ,055
3 months, .015 6 months .030 9 months, ,045 12 months ,060
1 days ,00017 11 days ,00196 ' 21 deys ,00362
2 days .00034 12 days .00203 22 days :00389
3 deys ,00051 13 days ,00220 23, days ,00386
,4 days ,00068 14 days ,OO~7 24 days .00403
5 deys ,00066 15days 00250 26 days ,0042D
6 days ,oo1D1 16 days .00267 26deys ,00437
7 days .00118 17 deys ,002B4 27 days ,00454
8 d"ys .00136 ' 18 d"y. ,003Dl 28 dsys ,00471
9 days .00152 19 deys ,00318 29 day. ,00489
10days ,00169 20 days .00335 30 days ,00600
__..... ________ ___ ___..........,100 _____ _,____ ___ :...---,:;..'---- -~- ---,-~~- -- - - -...'------~ ------
Any party in, interest, l~cluding the Commonweelth and the personal representative, not satisfied with
the assessment ,may object thereto within sixty (50) days' 8fter r~ceipt of this Noti,ee, as 'provided by Section
1001 of 1h.lnheritanC.. ond Estato Tax Act 011961 (72 P.S, ~ 24B6-1oo1),
Make check or money order pavable t():
"Rogistor of Wills. Agon'"
Mail to the address listed below;
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